A place for a tired old woman to try to figure things out so that the world makes a bit of sense.

Friday, December 17, 2010

Be Careful What You Sue For

I knew that at least one of my favorite Los Angeles Times business columnists would contribute to the discussion of the recent court challenges to the "individual mandate" of the Obama healthcare reform law, and I was right. David Lazarus' most recent column takes a look at the current ruckus. His opening sentence captures the issue quite nicely:

"What part of the insurance business do opponents of healthcare reform not understand?"

The only reason the health insurance industry agreed to come on board the effort to control rising medical costs was that they were promised a huge new pool of customers who would have to buy health insurance. In return, the insurers agreed to provide coverage for all who applied. It's called "spreading the risk." Healthy people who don't go to doctors often would help offset the costs of people with health problems who have to go to doctors often.

That's why the "individual mandate" is key to the reform, yet that element is what is sticking in the craw of so many conservatives.

I understand why the idea of an insurance mandate is troublesome to some people. Any time the government says you have to do something, it goes against the grain of good old-fashioned, don't-tread-on-me, live-free-or-die American values.

But here's the thing: If we want to rely on private companies for our health insurance, and if we want them to cover everyone, then we need to spread the risk as widely as possible to keep costs down.

Ironically, as Lazarus points out, in a recent poll almost the same number of people disapproved of the mandate as approved of the requirement that insurance companies accept all applicants.

So, what now?

Well, it's clear that the issue will be wending its way to the US Supreme Court. This is going to be a tough call for the conservative Roberts Court. If they agree that the mandate exceeded congressional authority, the insurance industry is going to be stuck with the bill. If they uphold the mandate, Congress is going to have a new tool in its arsenal, one that this Court doesn't want it to have. Quite a dilemma, that.

Of course, all of this could have been avoided by a Medicare For All bill. Even a viable public option would have done some good, but the insurance companies screamed and the right wing shouted, "SOCIALISM!!!!" So neither option was on the table right from the start.